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5 Reasons Why Insurance Claims Are Rejected


5 Reasons Why Insurance Claims Are Rejected

Are you a user of insurance services? Insurance is the prima donna for the protection of an asset from risks that may occur in the future. But, do you feel disappointed because your insurance claim was rejected? Do not be sad. Check out 5 reasons why insurance claims are rejected.

How to Use Insurance

Insurance is a means of protection to minimize the risk of damage that may occur in the future. The mechanism of protection from insurance is through an agreed cooperation between the insurer and the policy owner (individual).

The insurance utilization system is divided into two, namely direct cost coverage and delayed cost coverage. You can also read how to choose insurance online.

In the direct coverage system, activity costs (as agreed in the policy) will be directly borne by the insurer. Where ana, as the owner of the policy, does not need to pay a penny for the action.

In the delayed coverage system, the activity fee needs to be paid independently in advance by the policyholder. Later, the policy owner can file a reimbursement claim as a form of protection from the insurance.

However, there are some cases where insurance claims are rejected. So what's the cause? Here are 5 possible reasons why an insurance claim was rejected.

Reasons Why Insurance Claims Are Rejected

Claims Not Included in Policy Cover

The first thing that happens the most is the limit of insurance coverage. Sometimes the policyholders are not aware of the details of each selected policy.

For example the case in health insurance. You do dental treatment (scaling) without treatment. This action is not considered a health domain according to the policy, but beauty. When you make a claim, the application is automatically rejected

Incomplete Documents

More cases of rejected insurance claims are found in the use of reimbursement insurance. Where the policyholder needs to pay personally first, then submit a replacement claim.

One of the reasons why insurance claims are rejected is incomplete filing documents. Terms and conditions of completeness of documents depend on the insurance policy. Is it mandatory to attach the original receipt, must attach proof of payment in 4 copies, or must attach a drug prescription.

The Active Period of Insurance Has Ended

Have you checked the validity period of your insurance? Do not let the reason why your insurance claim is rejected is that the active period of the insurance corporation has ended and has not been extended.

This incident is actually rare. Considering that insurance agents must remind policyholders to extend insurance that will expire. Insurance renewal can only be done consciously by the owner of the police and is not automatic.

Unpaid Premium

Another reason why insurance claims are rejected is unpaid premium arrears. The insurer has the right to temporarily suspend claims service if it is found that the premium bill is in arrears.

You should know the mechanism of this policy at the outset. Especially for those of you who are periodic and long-term insurance policy holders. Check and pay attention to the cooperation clauses listed in the policy.

Insurance Agent Communication is Not Optimal

The biggest reason why insurance claims are rejected is the lack of good communication between the policy owner and the insurance agent he chooses. The previous 4 reasons could have been avoided if the communication between the insurance owner and the agent was good and communicative.

To overcome this problem, make sure you use the services of the right insurance agent. Where the agent provides detailed insurance product knowledge to you. It is not only limited to informing the benefits but also providing detailed information regarding the obligations of the policy owner

Those are 5 reasons why insurance claims are rejected. Hope this helps those of you who are looking for the answer.


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